It’s not as foolish a question as it may seem, as there is some confusion in womens minds about when it’s menopause, or perhaps perimenopause, or just symptoms relating to something else altogether.

I thought it might be helpful to try and clarify what it is and how it can affect us because the more information you have, the easier it is to handle it.

Menopause is the process a woman goes through that causes her periods to end and that is an entirely natural process for osteoporosis women, unless it is a surgical menopause through hysterectomy or cancer treatment for example.

It is easy to think of menopause in negative terms because of the huge effect some of the symptoms can have, such as night sweats, flushes, sleeplessness and weight gain. However it’s also a time to reassess and start a new phase and take control over potential age0related health risks such as heart disease and osteoporosis.

Why does it occur?

It is a natural part of ageing because it is the end of a woman’s childbearing years, brought on by the ovaries gradually slowing down.

Certain surgeries and medical treatments can also cause menopause as I mentioned, but having a hysterectomy without removing the ovaries does not necessarily lead to menopause immediately. However many women do find that the production from their ovaries does cease and it seems this can be sooner rather than later so the effects of menopause will be felt. ,

When does it start?

On average, and which of us is that, it is generally assumed to be around the age of 51 but menopause can start earlier or later.

A few women start menopause as young as 40, and a very small percentage as late as 60. Women who smoke tend to go through menopause a few years earlier than nonsmokers.

There is no proven way to predict menopause age. It’s only after a woman has missed her periods for at least a year without other obvious causes, that menopause can be confirmed.

Perimenopause

Natural menopause happens gradually. The ovaries don’t abruptly stop working, they slow down over time. The transition to menopause is called perimenopause.

Menopause is a milestone — it’s the day that marks a full year since your last period. During perimenopause, it’s still possible to get pregnant — a woman’s childbearing years are winding down, and although her periods may become more unpredictable, her ovaries are still working and she still may ovulate, though not always monthly.

What to expect

If you talk to your friends or female family members you will soon realise that menopause affects each woman differently. Some women reach natural menopause with little to no trouble. Others have severe symptoms. And when menopause starts suddenly as a result of surgery, chemotherapy, or radiation, the adjustment can be tough.

Some of things you can expect are:

1 Changes to your cycle

As menopause approaches, your periods will likely change. But again those changes can vary from woman to woman — periods may get shorter or longer, heavier or lighter, with more or less time between periods.

Such changes are normal, but check with your doctor if your periods come very close together, if you have heavy bleeding or spotting, or if your periods last more than a week as there can be a number of reasons for this including fibroids.

These are sadly ones of the most common symptoms and the most distressing for many women.

The feeling of heat can be brief or long, and can make the face and neck flushed and cause temporary red blotches to appear on the chest, back, and arms. Sweating and chills may follow and these can be more common at night, but do occur during the day too.

Hot flushes vary in intensity and typically last between 30 seconds and 10 minutes so plan ahead and if you are getting them during the day wear natural fibres, loose and light clothing and use a fan to help cool you down.

Exercise and avoiding spicy foods and high temperatures are good if you can manage that but in a hot summer or warm office that isbn’t always possible so take care of yourself as best you can.

There are three things that can really affect your sleep at menopause: an increased need to pee during the night, increased anxiety that stops you sleeping and night sweats that keep you awake.

To deal with these you first get your hormone balance under control and severe symptoms usually respond best to 20-1, which is a combination of bioidentical progesterone and two natural oestrogens with the progesterone being the largest ingredient.

If getting to sleep is the issue, rather than being woken up then try a specialised herbal combination such as Wellsprings Sleep capsules to help you, particularly in combination with your bioidentical cream as progesterone is known to help the body relax.

On a practical level keep bedding natural fibres, loose and cool as possible, keep the thermostat turned down and there are a number of gel mattress toppers and pillows specially designed to help keep you cool. For more immediate relief use a fan in your bedroom and keep a damp facecloth nearby to cool yourself quickly if you wake up feeling hot and sweaty.

Sex at menopause can be more uncomfortable due to you producing less oestrogen and that can lead to vaginal dryness, itching, and irritation. Try using a water-based lubricant and a combination cream that has some oestrogen in it will also help.

Libido can also be an issue as it is affected by many things, not all of them physical. Relationship problems, stress, some medications, depression and poor sleep all affect sex drive.

Also be aware that sexually transmitted diseases (STDs) don’t end with menopause so you may still need to use protection.

If you see your doctor, the conventional treatments for your symptoms may include low-dose birth control pills, antidepressants, blood pressure drugs and HRT.

In the USA The FDA (Federal Drug Agency) recommends taking the lowest dose that helps, and only for the shortest time because studies have linked long-term use of hormone replacement therapy to a greater risk of heart attacks, strokes, blood clots, and breast cancer.

In my experience women in the UK tend to be on HRT longer than the suggested 5 years and are often these days prescribed antidepressants when women are taken off HRT which do carry their own health risks.

Bioidentical hormones have been used worldwide for many years to help women with hormonal symptoms and other treatments that can help include acupuncture, herbal supplements and practices such as Tai Chi and Meditation which are shown to reduce anxiety and blood pressure when practiced regularly.